Background The clinical evaluation of viscoelastic properties of the Caesarean section (C‐section) scar, such as stiffness and elasticity, is usually carried out using subjective scales and palpation techniques. There is currently no reliable and valid tool that objectively quantifies these properties. The MyotonPRO could fill this gap. Materials and Methods Nineteen healthy women aged between 21 and 40 years with C‐section scars participated in this reliability study. Two points, one on the scar and one on unscarred skin, were measured four times successively with the MyotonPRO by three independent evaluators on the same day. The intra‐class correlation (ICC) coefficients were estimated using a two‐factor ANOVA to determine the inter‐ and intra‐rater reliability. The capacity of the MyotonPRO to discriminate the viscoelastic properties of the C‐Section scar against unscarred skin was assessed using the Wilcoxon signed rank test. Results The intra‐ and inter‐rater reliability of the viscoelastic property measurements was good to excellent (ICC 0.99‐1.00 and 0.87‐0.98, respectively). There was no significant difference between C‐section scar and unscarred skin in terms of elasticity (P = .737). Significant differences between C‐section scars and unscarred skin tissue were observed for tone (P < .001), stiffness (P < .001), creep (P < .001), and mechanical stress relaxation time (P < .001). Conclusion The MyotonPRO is a reliable tool for an objective measurement of the viscoelastic properties of the C‐section scar and unscarred skin. The MyotonPRO can discriminate the viscoelastic properties of the C‐section scar against the unscarred skin, for tone, stiffness, creep and relaxation times, but not for elasticity.

Background: Objectives of soft tissue mobilization applied to cesarean section (C-section) scars are to decrease stiffness and to reduce pain. Research investigating these effects is lacking. Materials and methods: The authors conducted a descriptive, exploratory, proof-of-concept clinical study. Women aged 18 to 40 years who had undergone at least one C-section were recruited. A trained osteopath performed standardized mobilization of the C-section scar once a week for 2 weeks. Scar quality and pain characteristics, viscoelastic properties, pressure pain thresholds, and tactile pressure thresholds were measured before and after each session. Paired Student's t -tests and Friedman's test with Dunn–Bonferroni adjustment were performed to assess the immediate and short-term effects of mobilizations. Kendall's W and Cohen's d were calculated to determine effect sizes over the short term. Simple bootstrapped bias-corrected and accelerated 95% median confidence intervals were computed. Results: Thirty-two participants completed the study. The Patient and Observer Scar Assessment Scale questionnaire revealed differences with small and moderate effects for stiffness ( p = 0.021, d = 0.43), relief ( p < 0.001, d = 0.28), surface area ( p = 0.040, d = 0.36), flexibility ( p = 0.007, d = 0.52), and participant opinion ( p = 0.001, d = 0.62). Mobilizations increased elasticity ( p < 0.001, W = 0.11), decreased stiffness ( p < 0.001, W = 0.30), and improved pressure pain thresholds ( p < 0.001, W = 0.10) of the C-section, with small to moderate effects. The results also showed decreased tone and mechanical stress relaxation time, as well as increased tactile pressure thresholds at the different measurement times ( p < 0.05), but trivial effect sizes ( W < 0.10). Creep showed trivial effect and no significant difference ( p = 0.09). Conclusion: This study showed that two sessions of mobilization of C-section scar might have a beneficial effect on some viscoelastic properties of the C-section as well as on pain. Some variables of interest useful for future empirical studies are highlighted. ClinicalTrial. Gov NCT04320355.

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